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Children with HIV may have less durable and lower antibody responses to pneumococcal conjugate vaccine
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Five years after a primary series of three doses of pneumococcal conjugate vaccine (PCV), children with HIV were more likely to have greater decay and lower antibody concentrations related to PCV vaccination than children who did not have HIV.
Researchers divided the children into four groups based on prior PCV vaccination and HIV serostatus. There were 31 children with HIV who had been vaccinated in infancy and 45 children with HIV who had not previously been vaccinated. Among children with HIV, 19.7% were being administered antiretroviral therapy (ART), and 40.5% had CD4 cell counts <15%. Among children who did not have HIV, there were 89 previous vaccinees and 110 children not previously vaccinated. All groups received a dose of PCV after baseline bloods were taken and antibody response measurements were repeated one-month later.
For both previous vaccinees and controls, children who did not have HIV had higher geometric mean concentrations of antibody and proportions with a concentration >0.35 mcg/mL five years following vaccination.
Children with HIV who had been vaccinated previously had lower antibody concentrations for three of seven serotypes following repeat vaccination than children who did not have HIV who were previously vaccinated.
The researchers determined post-vaccination antibody-mediated killing activity by assay. For all of the serotypes studied, detectable opsonophagocytic activity was lower among children with HIV than among HIV-uninfected between previous vaccinees and controls one month after the dose of PCV. Among HIV non-infected children, antibody required for 50% killing activity on the OPA assay was less than in previous vaccinees.
Madhi S. J Infect Dis.2009;199:1109-1111.